Chapter 1 20 This hearing screening consists of pure-tone audiometry. If the patient suffers from tinnitus, the tinnitus complaints, its onset and progress are inventoried. Further, the consequences of the hearing loss on everyday activities and participation are inventoried through self-report, including the difficulties with performing different auditory tasks and the NFR after work. The occupational physician may ask others their opinion about the consequences of hearing loss at work, such as the supervisor or colleagues. Personal and environmental factors are also inventoried by the occupational physician through self-report. The personal factors comprise the general health condition, the quality of sleep, psychosocial problems, and the coping strategies that are used. The environmental factors include the auditory work demands, the amount of noise and reverberation at the workplace, other workplace characteristics such as the work pace and the possibility to participate in job decisions, and the social relationships at work. After formulating the preliminary analysis, occupational physicians can refer to a general practitioner or ENT-specialist for a further assessment of the domain of anatomy and physiology. A referral is sent to an audiological center for further assessment of the other ICF domains, and – if needed – rehabilitation services. Hearing-critical jobs In some jobs, the inability to perform auditory tasks may cause a safety risk to the worker, fellow workers, or the general public (Giguere et al., 2008; Tufts et al., 2009). This is for example true in the military, since danger is posed by a soldier that cannot detect and localize sounds made by unseen adversaries in combat. Other workers that perform hearing-critical tasks include those operating vehicles, firefighters, miners, police constables, and law enforcement officers. Most of these jobs need to be performed in noisy workplaces with noise levels above 70 dBA. Here, difficulties with performing auditory tasks may occur, especially in employees with hearing loss (Soli, Giguère, et al., 2018). When hearing loss may result in difficulties with sufficient performance of crucial, auditory job tasks, job-related inclusion and exclusion criteria for employment can be applied to ensure that individual workers can safely and effectively perform hearing-critical job tasks (Soli, Giguère, et al., 2018).
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